Collaborative and Indigenous Mental Health Therapy

Tātaihono – Stories of Māori Healing and Psychiatry

Wiremu NiaNia, Allister Bush, David Epston

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781315386409
• Edition: 1
• Topic: Psicologia
• Subtopic: Ricerche e metodologie nella psicologia

This book examines a collaboration between traditional M?ori healing and clinical psychiatry. Comprised of transcribed interviews and detailed meditations on practice, it demonstrates how bicultural partnership frameworks can augment mental health treatment by balancing local imperatives with sound and careful psychiatric care. In the first chapter, M?ori healer Wiremu NiaNia outlines the key concepts that underpin his worldview and work. He then discusses the social, historical, and cultural context of his relationship with Allister Bush, a child and adolescent psychiatrist. The main body of the book comprises chapters that each recount the story of one young person and their family's experience of M?ori healing from three or more points of view: those of the psychiatrist, the M?ori healer and the young person and other family members who participated in and experienced the healing. With a foreword by Sir Mason Durie, this book is essential reading for psychologists, social workers, nurses, therapists, psychiatrists, and students interested in bicultural studies.

1
Introduction

Wiremu

Tēnā koutou katoa. This is my greeting to you, the reader. I welcome you to our book.

This book is a collection of true stories of Māori healing. The stories show the joining of a traditional cultural approach with the clinical approach of psychiatry and the forging of a working relationship between Allister and me that allowed this to take place.

In this chapter I will explain what the word matekite (seeing sickness or death) means and why I asked Allister if we could write this book together. I go on to talk about three Māori concepts that are intrinsic to all my work: mana (spiritual authority), mauri (life force), and tapu (something sacred or forbidden). In Chapter 2 we will look at the context to this mahi (work). In the stories that follow you will see these concepts in action and how they make a difference to the lives of the young people concerned.

Next, I speak about my background and how I eventually came to be working as a cultural therapist at Te Whare Mārie, the Māori mental health service where Allister and I met. Allister, who is a Pākehā (New Zealander of European descent) psychiatrist, will then tell how he came to be working in a Māori service and will give his account of how we began our work together.

You may wish to bypass all this kōrero (explanation), in which case I would encourage you to go straight to the stories that start in Chapter 3.

Matekite and Healing

I define matekite¹ as a kind of seeing that pertains to sickness and death. But it is a seeing that goes beyond normal human vision. I am descended from a long line of seers, and for me the most influential was my kuia (female elder), Te Awhimate Trainor NiaNia. I will tell you more about her in a moment.

Here is how I explain matekite:

Mā te kite ka mōhio, mā te mōhio ka kitea he oranga. (‘By the seeing, one will have knowledge; by that knowledge, one will find an answer.’)

And, of course, you can see that the first three words of this proverb combine to form the word ‘matekite’. This saying tells us that this kind of seeing has been part of healing in Māori culture going way back. And the meaning of this proverb relates to the reason I asked Allister if we could write this book together in the first place.

Awareness

We write these stories to show that there is more to Māori culture than just what you see in front of you. Since I was young I have often seen things; heard things; or even felt, tasted, and smelt things that others were unable to see, hear, feel, taste, or smell. If I had been seen by a mental health clinician and they asked me, ‘Are you seeing things?’ I would have said, ‘Yes’.

Consequently, I would be in danger of being misdiagnosed. I could have been labelled as having hallucinations or being psychotic. And I strongly believe this has been a problem for many of our people. When I say this, I’m not suggesting that mental illness doesn’t exist. But far too often the wairua side, the spiritual side, has gone unrecognised, which has had very negative outcomes for us as Māori.

In this book, we are inviting you to look outside the box. And if you are a mental health clinician, we are inviting you to look beyond the DSM.² We are by no means saying ‘abandon it altogether’. But we are declaring there are some matters it cannot explain.

My aim is to produce the kind of awareness that imparts knowledge that can be used to help heal those who are suffering. It is my hope that, armed with this knowledge, we mental health clinicians might make fewer mistakes in terms of diagnosing our people.

Explaining Things

In my mahi there are some matters over which I take particular care. One of these is explaining things to people. I want people to be able to understand what I’m talking about. I want wairuatanga (spirituality) to be less mysterious. I’m a people person. I believe there is power in knowledge and that power should be shared. I have more than one culture flowing in my veins, and I want both cultures to be knowledgeable about each other.

In the old days these matters were kept secret. There were good reasons for this. Sometimes such knowledge could be taken by others and used against us. For example, our Māori language was translated and written down, and before long there were Pākehā professors teaching Māori how to speak Māori, and native speakers of the reo (language) were deemed unqualified to teach it to our own people because we didn’t have suitable qualifications.

However, there are also more sinister reasons why such knowledge has been kept secret. In terms of the spiritual side, over the years many people have misused wairua—they may have used it to intimidate others or even for purposes of extortion. As a result many people ended up suffering.

I want this knowledge to be used for healing. I want people to understand about wairua so that they are not left in the dark and intimidated by it. I want them to have the knowledge and tools to become part and parcel of it. I want people to be participants rather than merely spectators. I hope you will appreciate how this has worked out for young people like George in Chapter 4 and Tangi in Chapter 7.

Mauri, Mana, and Tapu

Understanding these three concepts can help families make sense of wairuatanga. I have my own way of explaining mauri, mana, and tapu which you can read about in other chapters, for example, in my first session with Tangi in Chapter 7. The concepts are not easy to translate because they are relational terms and there are no English words that capture their essence.

A person’s mauri is often described as their ‘life force’. Even objects can have a mauri. But even more than this, mauri as it has been taught to me is about being in relationship to Te Kaihanga (the creator), who is the life force. Mauri is our connection to Te Kaihanga.

I view tapu as the sacredness of that relationship. Tapu also refers to the state of something that is sacred or forbidden, such as a person, a place, or even an object or ritual.

These concepts are illustrated well in Chapter 5 in Caleb’s story: mauri helps us understand how his unusual experiences came about, and understanding tapu helps us understand why those experiences happened in the first place. Caleb unknowingly breached a tapu, and as you read that story you will see that is one of the big learnings for him.

Mana is the spiritual authority, energy, or power embodied in a person or whānau (family) that comes from their relationship with Te Kaihanga and other key relationships. It gives them the authority to have control over themselves, their circumstances, and other entities that may be impinging on them. This is very important for people who are having unusual experiences that are spiritual but might be misdiagnosed as psychosis, such as hearing a voice or seeing something others can’t see. You will read about this in action with most of the stories that follow, particularly George in Chapter 4 and Tangi in Chapter 7. For these young people, gaining understanding about mana was necessary for their healing and reclaiming their well-being.

However, even though mana is about having authority over your space, it’s not about domination of others. It’s about having control over your own situation. It’s about being in control of your own behaviour and not hurting others. I use the concept of mana in my violence prevention work. Mana is about honour, it’s about your values and beliefs. It is also about protection. So if you are taking care of the mana of your family, then you are protecting them from harm, keeping them safe, and showing them respect.

Those of you who are unfamiliar with these three concepts may find them mysterious. In the coming chapters, however, you will see how they can be applied practically in your life, and how the remarkable young people we worked with made use of such ideas to take charge of their own lives.

Wairua and Christianity

In early 2005, I was employed as the cultural therapist at Te Whare Mārie, which is the name of the Māori mental health service in Porirua, near Wellington. It was here that I first met Allister. For me, starting work at Te Whare Mārie was significant because it was a Māori service. When I was young, my kuia often told me to learn the Pākehā ways so I could get a good job. I wish she was still alive to see me being paid to be Māori!

Even though it was a Māori service, run on a marae (meeting house), and had good cultural practices, there was limited knowledge about wairua in the team at that time. Naturally enough, for some people, wairua is all about their Christian faith. I don’t have a problem with that. For me, Io (God) is my source—I can do nothing without that. Anything useful, any healing, can only come from that source. It’s not me doing it. And the good thing about people who come to wairua from a Christian point of view is that most of them come in a way of love. And God is portrayed as love. I think this can be very healing. You can read about the healing power of a grandmother’s love in Shannon’s story in Chapter 3 and a mother’s love in Chapter 4.

There is a waiata (song) that says: ‘Whakarongo ki te reo, e pupū ake nei. Ko te reo aroha.’ It means, ‘Listen to the voice that bubbles forth. It is the voice of love.’ For me, the voice of love is no different from the voice of God.

However, there are limitations to this viewpoint. Christianity got very tied up in colonisation. The Bible was used to dispossess us of a lot of land—in that way it was misused and even abused. And in more subtle ways Christianity dispossessed us of some of our old understandings about wairua. For example, anything unseen that isn’t understood often gets labelled as demonic, and that’s not helpful. I don’t go along with the idea that the Christian way is the only way. If the spiritual destination is the same, then it doesn’t matter how we get there as long as we are all moving in the same direction. If I was going along in a beat-up old Holden, and someone else had a limousine, and someone else was on a Yamaha, it doesn’t matter as long as the goal is the same. It’s about respecting one another, no matter what vehicle you happen to be travelling in.

I often refer to Io as God. Io consists of two sounds: the ‘I’ is the essence, and the ‘o’ is the enormity of that essence. Reverend Māori Marsden (Royal, 2003) described Io this way:

All existent being derives from a common centre. Everything depends for its existence, whether in this world, or in that behind it, upon mauri (life-force) which originates in Io-take-take (Io-the-first-cause). Io, whose mauri is primary and whose mauri both unifies all things and at the same time bestows them with unique qualities, provides for unity in diversity. Man is therefore an integral part both of the natural and spiritual order, for mauri animates all things. From this basic conviction derives the holistic approach of the Māori to all life.

(p. 95)

For me, there is no difference between Io, the Christian God, or any other version of God.

When you read the stories you will notice that I make use of biblical references in my mahi. In fact, I’ve never read the Bible, but many of our whānau have been influenced by Christianity. I use those references so that people might find the wairua concepts easier to relate to. We’ve been doing this for a long time. Te Kooti used psalms from the Old Testament in his teachings, and the prophets Wiremu Rātana and Rua Kēnana often referred to the Bible in their kōrero.

Early Guidance

My kuia Te Awhimate guided me in my life in so many ways. She was recognised as a matekite (seer of sickness or death) and became known in our whānau for her healing practice. Many times I witnessed her doing mahi wairua (spiritual healing work). My earliest memory goes back to when I was three years old. I remember I would wake in the early hours of the morning. I would get up out of bed. I felt like I was being led towards the door of our whare (house). I can clearly recall seeing the door handle that was too high for me to reach turning and opening of its own accord. I would walk out of the whare and into the paddock. At that point I would hear my Nanny yelling out to me, ‘E Wire, kia tūpato!’ (Wiremu, be careful!). Her cry would snap me out of it. Afterwards Nanny would reassure me, ‘We need to look after you, we need to be careful with you!’ and she would tell me stories of people who had certain gifts who had been ‘taken’. Because of their gifts, she believed that they had been vulnerable to tūrehu (spirit creatures).

Many of the principles I use in my mahi today came from her influence. For example, I’m always looking for an opportunity to whakamana (strengthen the mana of) a young person or whānau that I’m working with. I first saw this with my Nan, who always made sure to enhance the mana of those around her. She was herself a very humble person. I later learned the hard way that I had to be vigilant about this in my mahi for my own spiritual well-being. She had a saying, ‘Me whakaiti koe i a koe, mā ētahi koe e whakanui’, which meant: ‘You must always be the least, and let others raise you up.’ That was a whakatauākī (proverb) that she not only instilled in us but expected us to live by. It was permissible for others to praise our whānau, but we were not to put ourselves up. We were to be the least of the least.

My Nanny was also very careful about the power of words. I remember her telling me as a teenager, ‘Because of the gift you have, you must never speak ill of anybody, even in anger. Do not swear at anybody. If you do, you could do them harm.’ I learned to be very careful about what I said to people, especially if I got angry.

There was another form of protection that my Nanny insisted that I live by. She believed that spiritual dis-ease could result from unresolved conflict, or raruraru, between people. Her philosophy was ‘Utua te kino ki te pai’, which means ‘bless or do good to those who would curse or harm you’. She insisted any disagreement be resolved promptly: my Nanny lived by the saying that you should never let the sun go down on your anger. These are just a few of the many healing principles she passed down to me.

Our whānau spoke only te reo Māori (Māori language) and so, because I suddenly had to speak English for the first time, starting primary school in Tiniroto was a real shock for me. I left school when I was 13, and over the years since then I’ve worked in many roles. I was a shearer, a fencer, and a scrubcutter. Later I worked as a musician and a songwriter. I was also a Māori activist and youth worker. As a teenager I got involved in the gangs and ended up in jail for a time. Those experiences instilled in me a real passion for youth work. After working with youth at risk for a long time, I joined the crisis mental health team at Gis-borne Hospital as a cultural worker in the late 1990s.

Working Together

Allister and I were on the same team at Te Whare Mārie for about two or three years before we started to meet families together. Maybe we needed that time to suss each other out. I could see that he had few peers when it came to the clinical side. But he approached things differently from other doctors I’d worked with—almost in a Māori way. Ngāwari is a word that means going with the flow, a considerate, peaceful manner. Allister would think of the things that could be peaceful first, rather than criticising someone: he would look for a solution before going into it gung ho and knocking all the walls down. Another thing that caught my attention was his openness about spirituality. I could tell he was already on his own journey there. Despite his obvious clinical knowledge, I noticed that he was prepared to explore an avenue other than one he was familiar with. He wasn’t just saying, ‘This is a clinical thing and I have all the answers.’ If people were in any way concerned about where they were with the cultural side of their experience, he would say, ‘Well, I know someone who might know something about this. Would you like to meet with him?’

After a while Allister and I got to talking about a young person we were meeting with together. That was Caleb, who you will read about in Chapter 5. Allister asked me all sorts of questions about how to understand Caleb’s situation. Later, with Caleb’s permission, we presented a talk to the local psychiatrists’ group about what happened to him—the doctors were interested. And some time later, after we had been meeting other families together, I suggested to Allister that we could write a book about our work together. Even though I left Te Whare Mārie in 2010, Allister continued to consult me about young people and families with wairua problems, and we usually collaborated on this mahi.

Some people might...